New Costs for Tests, Vaccines and More

In January, White House officials revealed plans to bring the COVID-19 national and public health emergency protocols currently in place to an end. The move to slowly cease funding to public health programs designed to help Americans navigate the pandemic was revealed by officials as they announced a target end date in late spring 2023.

You may have heard of the initial announcement outlining the White House’s plans for ending COVID-19 emergency declarations across states, but there’s been some confusion over which elements of healthcare may be affected. Many are equally concerned about the effect that the end of the public health emergency will have on Medicaid, specifically, as states won’t be restricted from withdrawing Medicaid from recipients who no longer qualify for the program starting in April.

Since the global pandemic began in March 2020, Americans have had access to free COVID-19 tests in one form or another; whether through USPS-sponsored home delivery of rapid antigen tests, or community-run polymerase chain reaction (PCR) testing offered in many public health clinics. The same can be said for COVID-19 vaccines, which have been offered to the public for free regardless of insurance coverage in years past — all of which was due to funding tied to emergency federal healthcare policies.

In May, the costs of both COVID-19 tests and vaccines will largely be passed back onto Americans, and the kind of insurance you have will play a role in how much you’ll need to pay in the future. Below, we’re outlining how the end of the public health emergency will impact COVID-19 tests, vaccines and costs associated with treatment and care, according to plans highlighted by federal officials.

Some of the information in this story may have changed since it was last updated. For the most up-to-date information on treating COVID-19, please visit online resources provided by the CDC, WHO, and your local public health department.

When is the end date for COVID Emergency Declarations?

White House officials have confirmed that COVID-19 emergency declarations will officially cease on Thursday, May 11, and have told the press they do not plan to extend these declarations once again. A final extension granted this January gave the public around 60 days to maximize any benefits they may currently be relying on.

Federal officials say a reduction in hospitalizations and overall COVID-19 deaths led administrators to formally terminate declarations tied to the public health crisis. CNN reports that a spokesperson for the White House indicate that this final extension will allow healthcare providers and patients to better transition into a new format for billing COVID-19 care; administrators are closely reviewing other policies authorized as part of the public health emergency to see if any will be extended on a case-by-case basis after May 11.

How will COVID-19 testing be affected?

Many Americans have been taking advantage of provisions within national emergency and public health emergency declarations — specifically those that provide up to eight rapid at-home COVID-19 tests each month through Medicaid, Medicare or private insurance. Unfortunately, that benefit will be coming to an end in May; the type of insurance you have will largely affect how much you’ll need to pay for tests in the future.

According to materials highlighted by the Kaiser Family Foundation (KFF), a future co-pay — whether it’s for a formal PCR test or a rapid antigen test you’ll find on pharmacy shelves — largely depends on your insurance provider and the state that you live in. It’s expected that the distribution of free tests through USPS will come to an end, but Americans are still eligible to maximize funding benefits now and essentially stockpile a few months’ worth of home tests before May 11.

Daniel Rhoads, M.D., a clinical microbiologist at the Cleveland Clinic and vice-chair of the College of American Pathologists‘ Microbiology Committee, tells Good Housekeeping that those who aren’t able to leverage insurance policies can expect to pay at least $10 per individual antigen test beginning in May. “A typical charge for PCR analysis that’s performed in a laboratory to detect SARS-CoV-2 is at least $100,” he says, adding that a PCR test that tests for influenza or RSV simultaneously may range much higher in price.

That could quickly add up, especially as some doctors tell patients to complete multiple antigen tests to try and overcome what experts know as a “lower sensitivity” for at-home test kits.

Dr. Rhoads adds that Americans need to exercise caution when stockpiling free COVID-19 tests before emergency declarations end this spring. While rapid antigen tests may have a shelf-life that extends up to two years, expired tests are likely to fail in detecting COVID-19, providing a false negative for someone who may be unsure of their symptoms. “With antigen tests, the sensitivity of the test might be decreased if used past its shelf-life,” he explains. “That is, it could fail to detect the virus when it is actually present.”

It’s true that some manufacturers recently worked with the Food and Drug Administration to extend their expiration dates, Dr. Rhoads says. But you shouldn’t expect that COVID-19 tests secured this spring will be still accurate to use a year after the May 11 deadline — after all, most expiration dates were only extended by seven months. “When shopping for tests in a store, each package will list an expiration date, which is crucial to review before you purchase them [for stockpiling],” he adds.

Seniors who rely on Medicare will no longer receive free at-home COVID-19 testing through their plans, whereas Medicaid recipients will continue to receive tests as long as they’re ordered by a physician, according to materials published by the KFF.

Will COVID-19 vaccines still be free?

It’s true that both Pfizer-BioNTech and Moderna have been looking at raising prices of their COVID-19 vaccines to upwards of $130 per dose. Because emergency declarations are ending, in many cases those without any insurance coverage may be required to pay out of pocket for vaccines, depending on the state they live in. Ultimately, it may be up to private insurance providers to determine whether they will cover timely COVID-19 boosters like they do annual flu vaccinations.

It seems that Americans who hold private insurance may not have to pay for COVID-19 vaccines or boosters as long as they receive them from an in-network healthcare provider, according to the KFF. If you’re currently not up to date on vaccinations and hold private insurance, federal programs indicate you won’t have to pay for a booster shot regardless of where you receive it before May 11.

The same KFF analysis suggests that Medicare policyholders will be able to receive free COVID-19 vaccines in the future due to the federal CARES Act, and Medicaid recipients will also continue to receive free vaccinations indefinitely.

Will COVID-19 healthcare be covered?

Due to the introduction of emergency declarations in 2020, most states waived pre-existing rules that determined who could access telehealth care and where they could do so. But geographical restrictions may come back in May, as states will decide if Medicaid policies will continue to cover access to telehealth, whereas Medicare plans will cover some services through 2024, the KFF indicates. Private insurance co-pays for Americans who are feeling sick, or test positive for COVID-19 at home, and turn to virtual doctors for access to treatments are likely to increase in May.

In particular, those requiring the antiviral drug Paxlovid may be formally charged for the drug, whereas emergency declarations meant full coverage for most in years past. Those with private insurance and Medicare plans may face a range of pharmacy co-pays starting in May, whereas Medicaid recipients will continue to access free pharmaceutical treatments through September 2024. Only Paxlovid purchased by federal government providers will remain free, but patients may not be able to access the federal stockpile through care providers in their area.

The bottom line:

It’s unclear just how expensive treating or preventing COVID-19 will be for most Americans currently — but a majority can expect to face new forms of co-pay for tests, treatment and medications starting in May. As COVID-19 emergency declarations come to an end, experts say the clearest impact will be costs associated with COVID tests, both PCR tests performed by clinicians as well as prices for at-home antigen tests. Costs will likely exceed $10 per individual antigen test (upwards of $20 per box of two tests sold at pharmacies) and Americans may face bills higher than $100 for performing COVID-19 tests in clinics across the country.

As reported by CNN, the Biden administration has also announced that it currently doesn’t have funding available to replenish vaccines, care options, medications and tests for those most in need. It’s unclear if costs associated with COVID-19 healthcare will continue to surge once federal supplies are fully depleted.